Abstract
Background: The burden of HIV/AIDS has reduced following sustained interventions especially with introduction of highly active antiretroviral therapy (HAART). HIV/AIDS has become a chronic condition for which adherence to therapy is of public health relevance. This study was aimed at assessing the relationship between adherence to HAART and clinical and laboratory outcomes in a tertiary centre. Methodology: This was a cross-sectional descriptive study of three hundred and forty eight (348) respondents on HAART. Adherence was measured using an adapted adult AIDS clinical trial group (AACTG) with optimal adherence set at ≥95%. Clinical stage, anthropometry, CD4, total lymphocyte and haemoglobin were used to monitor clinical, immunological and haematological outcome of adherence. Result: The mean (SD) age of respondents was 34.8 (5.3) years, ranging from 18 - 68 years, with male: female ratio of 1:1.7. Adherence to HAART was 89.1%. Non-adherent compared with adherent respondents, had marginally significantly higher proportion of WHO AIDS Stage 3 disease (44.7% vs. 26.4%, p=0.05). Comparing baseline with current values, change in mean CD4 cell counts was significantly higher among adherent compared with non-adherent respondents (187 vs. 125, p=0.00). Also, change in mean total lymphocyte counts was significantly higher among adherent compared with non-adherent respondents (508 vs. 314, p=0.00). Change in CD4 cell count significantly correlated with adherence (t=0.15, p<0.05). Conclusion: Self-reported optimal adherence significantly correlated with immunological recovery, which is a key determinant of good clinical outcome in HIV patients. Measures aimed at sustaining adherence to HAART, and regular assessment of CD4 count should be strengthened.
Highlights
Sub-Saharan Africa (SSA) with just over 12% of the world’s population has the greatest burden of Human Immune deficiency virus (HIV) disease with 24.7 million people living with HIV, accounting for about 3% of its population (UNAIDS, 2014)
Self-reported optimal adherence significantly correlated with immunological recovery, which is a key determinant of good clinical outcome in HIV patients
Measures aimed at sustaining adherence to highly active antiretroviral therapy (HAART), and regular assessment of CD4 count should be strengthened
Summary
Sub-Saharan Africa (SSA) with just over 12% of the world’s population has the greatest burden of Human Immune deficiency virus (HIV) disease with 24.7 million people living with HIV, accounting for about 3% of its population (UNAIDS, 2014). There has been a general decline in new HIV infections and AIDS related death in sub-Saharan Africa with different countries having different rates of decline. Nigeria being the most populous country in sub-Saharan Africa has more than 3 million people living with HIV/AIDS and the cumulative HIV- related deaths in the country is placed at 2.1million (UNAIDS, 2014). The introduction and widespread use of highly active antiretroviral therapy (HAART) as the treatment of choice in patients with HIV infection has improved significantly the clinical condition of people living with HIV/AIDS (UNAIDS 2014; Cotton et al, 2006). The. The burden of HIV/AIDS has reduced following sustained interventions especially with introduction of highly active antiretroviral therapy (HAART). HIV/AIDS has become a chronic condition for which adherence to therapy is of public health relevance. This study was aimed at assessing the relationship between adherence to HAART and clinical and laboratory outcomes in a tertiary centre
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